Tonight

Patient to me: "I just couldn't stand this abdominal pain any more, so I got to thinking.... maybe I could do surgery on myself, just cut myself open and do some surgery to fix it myself."

Me: "And now that you're reflecting back on that thought... what do you think, was that a good idea?"

Patient: "I'm not sure."

Cross-cultural licensing

My husband was trying to drag me to the department of motor vehicles, because he has a fascination with getting things licensed. I wasn't very interested, and if left to my own devices, I would probably require at least a speeding ticket to prompt me to change my affiliation. After all, the department of motor vehicles is boring, right?

When we arrived at the licensing center, which was located in an unassuming strip mall, with its title in large red letters "Driver's License" being the only marker for its presence. We walked inside to find a cross section of society waiting in line. Hispanic would-be gangsters in gold chains with tattoo sleeves, African women draped in traditional robes and hijabs, and, most intriguingly, a large black man wearing a mask. This man was wearing a disheveled, discolored white T-shirt and sweatpants. He had short dreads and red sneakers. He also had on a red facemask, the sort you would wear if you were attending a costume ball or Carnivale. "Excuse me, is this the line?" We asked. "Yes, the Red Hornet is in line, you bet," he said. The Red Hornet turned to his friend, who was wearing a white t-shirt that was basically an amalgam of stains, and a baseball cap with a dollar bill pattern on it. "They gonna try to get me to remove this mask," he told his friend, who smiled. "'Cause being a superhero, the police always got to be chasing you. They always got to be in your business." "Mmm-hmmm." The friend agreed. The Red Hornet continued his very loud, masked soliloquy about the difficulties of being a superhero at the DMV until he reached the front of the line. He seemed ready to make a grand social statement. I was disappointed when he finally walked up to the desk and, mask off, began to act like a completely mundane customer.

After taking a computer test to get my new license, we walked to the counter where the vision testing was taking place. "Put your forehead to the bar," the DMV staffer was saying, to a woman in a beaded turquoise hijab. "Now where do you see the flashing lights?" The woman pulled back her head and stared at him. "Did you see the flashing lights?" He asked. She nodded uncertainly. "Where were they?" She didn't answer. "Put your forehead back to the bar and look for the flashing lights," he said, pointing. We watched as this scenario repeated itself about 10 times, with the staff member getting progressively more frustrated each time. "Do you SEE the flashing lights?? Tell me where they are!" He gestured wildly at the machine. The woman would look at him uncomprehendingly, but she refused to give any answer that might incriminate her. You could see her eyes were searching his for the right answer. Eventually he managed to coach her through giving him the answer. This encounter made us wonder - what exactly are the criteria by which a driver's vision test is judged? If a person cannot understand a simple instruction in English after several repeated attempts... shouldn't this disqualify them from driving on roadways where the signage is in English? Or is the purpose of the test as far as the DMV goes simply to actually ensure that each eye is working?

Farmer's Market Flood

My first farmer's market in a place where farms abound. This put my suburban farmer's market experience to shame - row upon row of booths from vegetables to dairy to meats, with a couple of folk singers strumming in front of their open guitar cases in between. The peddlers ranged from grandmotherly types selling homemade jams, jellies, and pies, to southeast Asian immigrants selling bunches of Thai basil.

The trucks selling meats had menus an arm's length long, with sausages and sandwich meats, steaks and bratwursts. The Amish were there selling pastries from the back of their truck (yes, they had a truck too), and the Norwegians staffed the lefse tent. I tasted my first lefse - like a heartier crepe, rolled with butter, sugar and cinnamon.

As we purchased a small loaf of banana bread, the shopkeeper glanced at the sky. "Did you hear? There's a big storm coming." "No, I didn't realize," I said, and went merrily strolling towards the next booth, assuming that I should batten down the hatches for later that afternoon. A few minutes later, tall, dark clouds were looming to the west. The storm was bearing down on us, and we realized we only had a few minutes to reconnoiter. "Quick, the $3 raspberries! You get the Amish cinnamon rolls! A small bag of spring mix, please?" The farmers were grabbing and stacking dollar bills as quickly as they could collect them, one eye on the sky, and one eye on their wares, desperate to maximize the take before the storm bore down on them. Shoppers were streaming out from the marketplace, including the acting troupe who had been performing the Music Man - they crowded towards the exit in their suits, straw hats and frocks, singing in harmony as they went.

As we fled towards our car, we could hear the rain roaring towards us like a watery curtain, the shrieks from soaked pedestrians getting closer and closer by the moment. By the time we were in the car, the rain was pelting down on the remaining marketgoers and sellers. Puddles were beginning to stretch along the roads. The sky had completely transformed itself with the suddenness of a solar eclipse. And we departed the farmer's market to make our local lunch, marveling at the fury of a Midwestern storm.

For Sujal

They taught us in school how to see it.

Danger, hidden as it may be
Within ourselves, or around the corner.
That’s how you knew danger lies
Not in romantic places, where one thinks of it:
Rocky cliffs, or deep in the waves, or the sudden flame of an explosion.

You saw danger hiding in our everyday
Apathy, the same apathy that leaves cancer to run reckless
Through a body. It’s in our hearts, and you told us
Not to wait, that momentum is the only cure.

So I know that if I said, “don’t go—
It’s dangerous.” You would have laughed.
The danger is here and now, in the simple ways
We expect it, still catching us unprepared.
That’s why I’m not surprised death came for you that way,
Prosaically, the death we see daily on the streets,
Walking languidly between the wheels and the curb.
The part I can’t accept is- I know
When pushed into the air, you wouldn’t fall,
You would only rise. To fall isn’t in your nature.
When the force of your convictions struck
Against those more mundane forces of gravity or attraction,
I know reality could never stop a dream in motion.

(c) 2010 Alison Hayward

Remembering

My friend Sujal was in a serious car accident a few days ago in Uganda. He was on a motorcycle taxi struck by another vehicle and sustained severe injuries. As it turns out, he was never stable enough to transfer out of the country. He passed away last night in Uganda, and a large community of friends is mourning his loss today.

I would like to tell you a little bit about Sujal and my memories of him. I first encountered Sujal in early 2005, when he applied for a position on one of the UVP summer teams. After acceptance, I noticed that he was always the first to respond when I sent e-mails to the team members, and that he asked many insightful questions about the trip. Although he was only 18 years old, the minimum age for participants in our program, I knew that he had the potential to be a great team leader, and I asked him if he would be willing to lead a team. Sujal was not one to take commitments lightly, and he asked if we could have a phone conversation so he could learn more about what was involved. I clearly remember calling Sujal while I was on a ski vacation, describing Uganda and our teams to him, impressed by his maturity which was beyond many other participants despite being much younger. He agreed to become a team leader, and went on to lead a successful team effort working in the village of Ibulanku with our partners at People and Development Initiatives clinic. He turned in an excellent report of the summer's work, and I ended up entreating him to join our executive board. I wanted to harness his energy, intelligence, and care for those living in poverty. Again, he carefully considered the decision, asking me for copies of many pages worth of documents he wanted to read about the organization before deciding. He read them all, and UVP was in luck - he decided to join the board as treasurer.

He attended our annual board meeting and consistently arose as a voice of reason and insight into what would be most helpful for our communities. Although he was new to the experience of working in a developing country, he had an innate sense of what was right. After an excellent performance as treasurer, he continued to be one of our most involved alumni, year after year requesting to remain on our board of trustees. He attended in person meetings, online meetings, and he responded to innumerable e-mails. I have worked with many people interested in global health, but Sujal was one of the rare people who put his convictions, truly, into practice. (how difficult it is to write that he "was"! Instead I would like to change that to 'will always be'...)

Just in the past few months, Sujal had become involved in a number of initiatives with Uganda Village Project - pushing us to become more involved with researching our programs and presenting that research to others. He practically single-handedly spearheaded an effort that resulted in our presenting of 4 different research abstracts at a national conference in Kampala last month. Not only that, he was the sort of person who joined in on conversations about how to improve our organizational technological capacity, and other such details that others might consider minutiae. He would become really involved in the conversation, giving real consideration to the options and weighing them. Those who work with organizations that function online know what a rarity this is, and how hard it is to find the people who always respond to questions and concerns immediately. The people like Sujal, who really care about what they do, even though it is not for school, not for credit, not for work - just for making the world a better place, in their spare time.

That is what I loved about Sujal, and why I knew that he was going to have a huge impact on global health and human rights. He wasn't in it for prestige or for power, he was becoming a leader so that he could create positive change in the lives of others.

The strange thing about the way our lives intersect in the age of the internet is that I am able to have very close relationships with people whose faces I hardly ever see, whose voices I hardly ever hear, but yet I feel that we are good friends. There are a number of people, through the nature of how Uganda Village Project works, who I correspond with on a near-daily basis, sharing ideas, thoughts, jokes, and conversations with, and yet- we are many miles apart. My friendship with Sujal was like that. I had a very small wedding, and I invited him, even though we hadn't seen one another in person more than a handful of times. And now, I feel like there is an empty hole in my life, even though it's hard to explain how a person who you had a relationship with over the internet can leave a hole like that.

Here is how I heard the news about Sujal. He had given me a great deal of advice, because I was nervous about traveling to India for the first time. He had also given me the contact information for his aunt and uncle and urged me to meet them and have dinner with them. I could tell they were as kind as Sujal, because sight unseen, they offered me a place to stay while I was in Baroda. The day before I was scheduled for dinner with them, he called to ensure everything was all set. I showed up at their house and they were incredibly welcoming, and set out a veritable feast of delicious Gujarati food for me. I was afraid I might not like it, being a picky eater, but it was all so good that I had seconds and thirds. And even after I ate the seconds and thirds, his auntie and uncle kept giving me more, until I had eaten fifths and sixths. I ate until I thought that I might actually explode, and I had to stop because I couldn't swallow another bite.

At that point, we moved back to the living room, and his auntie showed me a magazine featuring Sujal's cousin, a vascular interventionalist, on the cover. After I read the article and commented on how proud they must be, they said how they loved to hear about the successes of their nephews. And then his auntie said to me "We were going to take you to the Navratri festival tonight, but we cannot go now. We have had some very bad news." "What's wrong?" I asked. "We have had some very bad news." She repeated, as if she couldn't bring herself to get to the news, pausing a moment. "Sujal has been in a terrible car accident. He is in a coma in the hospital." I just looked at them, and my mouth was opening and closing, and nothing was really coming out. They had known since before I arrived, but didn't tell me so that it would not ruin the dinner. Even though a terrible tragedy had befallen someone who was like a son to them, they were thinking of my wellbeing, and cooking food for me to enjoy. I felt like an intruder into their grief. And I had to steel myself so that they would not see me falling apart - I did not want them to think that I suspected the worst, even though I did, because a coma plus an accident equals a traumatic brain injury. The rickshaw man looked at me strangely as I cried in his backseat, all the way to our destination, watching the motorcycle taxis dodge in and out of the chaotic nighttime traffic.

missing you, Sujal.

Worrying.

I heard yesterday that my good friend in Uganda had a serious accident. I am terribly worried about him and waiting for a call from his family to find out how he is doing. It is hard to think about anything else. Please, let him be all right.

Day 9: Champaner/Pavadgarh

The sessions of the conference running today were about leadership, and I had to decide whether to attend or to go touring in the Gujarati countryside. I suppose some would say you can always learn more about leadership, but I wasn’t inspired for today to be the day for me to do that. I enthusiastically took off to tour a World Heritage site called Pavadgarh, about a 1 hour drive from Vadodara.

The part of Gujarat where we are is very flat and basically looks sort of like marshlands or jungle floodplains. But oddly enough, as you approach Pavadgarh, there is this giant cliff that rises up from the plains, and we were headed for its peak. You can hire a rickety old SUV to bring you up the steep cliffside most of the way through a series of hair-raising switchbacks, but many intrepid pilgrims are hiking all the way up this thing. The most entertaining thing about those traveling on foot was that they were organized into small bands of people, typically the majority of them wearing matching red, pink, or orange headscarves, or even matching T-shirts too. Each ‘team’ usually carried a flag or a banner, basically just homemade from scraps of bright fabric and metallic bric-a-brac. Some of the most elaborate teams even had these musical carts with them, that had drums attached and a bullhorn so that their music was amplified around them. The teams would be singing and cheering as they hiked their way up, and would wave and cheer harder as we passed by.

When we reached the top of Pavadgarh, there were further crowds of people and a meandering walkway through an old bazaar where people were selling trinkets for the pilgrimage like headbands and pictures of gods and goddesses. This place was full of oddities and points of interest, for example, as we turned a corner, a herd of donkeys decorated with orange paint stampeded by. Yes, you heard me right, they were donkeys painted orange, although later my fellow traveler joked that perhaps they were tigers in disguise. You can either hike up the stairs, a lengthy climb, or take something called “The Ropeway of the Gods”, which is a cable car to the peak. I can testify that only the most serious of hikers should undertake the stair pathway. It is lined with kilometers worth of further hawkers and souvenir stands, which is sort of impressive. We hopped on the cable car and were treated to lovely views across the Gujarati countryside of lakes and fields. The cliffs of the mountain were lined with ruins in various stages of decay, even ruins that looked basically new. There were also mini-altars and shrines all the way up. I was blissfully happy as we climbed to find that no one on this mountain seemed to speak any English whatsoever, so if they were trying to harass me, sell to me, beg from me, I don’t know, because we couldn’t understand each other. It was wonderful. I did notice that the few English words I heard came from beggars, such as ‘look!’ (pointing at stump where leg should be) and ‘hello!!’ (thrusting bowl into tourist’s chest).

Most of the shops sold Hindu trinkets and offerings to bring to the temple such as coconuts, small loaves and bags of sweets. My favorite shops, though, were these funny little ‘photo booth’ shops. The photo booth shops were just empty rooms with wall coverings made to look like mountainous scenery, with representations of people and gods on them as well, and you would get your photo taken in front of these backgrounds. Most of these shops also had large props you could put in the photos, specifically large stuffed tigers and toy motorcycles you could sit on. I was dying to get my photo taken with the giant stuffed tiger (preferably with both of us astride a toy motorcycle), but was too shy to do so and settled for taking a surreptitious photo of the booth. One of the booths had a life-sized stuffed llama.

We eventually processed up to nearly the top of the mountain, where a very steep stone staircase led to the temple itself. There was a pile of shoes by the base of the stairs, which gave my less-traveled companions pause. I was wearing a junk pair of flip flops that I kicked off, but some were wearing expensive shoes like Tevas and Merrells. They continued on. We climbed the staircase, sweating and puffing, past little carvings of gods that each had red ink on their foreheads. We finally reached the temple and queued to reach the altar. As we waited in the queue, banshee screams started coming from inside the temple. For a moment, I almost sprang ahead shouting  ‘do you need a doctor?!’ but I didn’t, based on two things, #1, no one else was moving or looked concerned, clueing me in that this might be some cultural phenomenon. #2, I realized that to some extent, I’ve heard enough screaming in the ER that I can tell a hysterical scream from a true scream of pain or distress, and this sounded like a hysterical scream. My suspicion was confirmed when a woman lurched out of the temple and pretended to faint into a policeman’s arms, waving her arms wildly. There was a 13 year old girl next to me from our group, who looked scared and said ‘did that woman just pass out?’ I said ‘no, she is just being dramatic. Don’t worry.’ And surely enough, the woman picked herself up and walked out, having been dispossessed of the spirit.

A few minutes later, more screams came from behind me. I looked in their direction, and realized the screams were being made at members of our group. “Shoes!! No shoes!! No shoes!!” Angry pointing and gesturing by the crowd accompanied the screams. Luckily, I had a little cloth reusable bag inside my handbag, and we hid all the shoes inside this, although much glaring continued to ensue.  As we processed through, a girl approached and said in surprisingly good English: “I am sorry, it is not my place to say things to you, but please do not ever bring shoes into a holy temple again.” We had become very unpopular visitors.

Inside the temple was an altar where two men were busily collecting offerings. They would touch some of the items, like the small loaves, to the temple wall. The strangest aspect of this little white stone temple was that just above the altar was a large digital clock face that was meant to display the time and date. The time was mildly incorrect, but the date read “1, 1, 2000”. Curiouser and curiouser…

As you exited the temple, the actual external walls of the stone building were thick with red, pink, and orange powdery vegetable dye, like the dye was actually seeping out from the walls. Some women had small jars or pieces of paper that they were collecting this powder into and taking it with them. Others, like me, just pressed their finger into it and touched our neighbor on the forehead. It’s good luck, or so I am told. I noticed that as you passed down the stairs, there was a little cave in the rock you could peek into, and inside the crevice, a pair of eyes were painted onto the back wall, and several small offerings had been pushed into the cave. These eyes were apparent in a number of locations in and around the temple, and prompted offerings wherever they were found. I assumed that the message was something like, god is watching you, so you’d better be good. But that may be just my wacky Western Christianized viewpoint of it.

We drove home and my companions joked most of the way back about how the temple visit was a hot, tiring ordeal and not worth seeing, but I found myself quite enamored of this strange place and happy with the journey.